If you’ve ever had the misfortune to need an out of hours vet, either at night, on a weekend or on a bank holiday, then you will know that the fees involved will often be higher than the regular daytime ones, sometimes markedly so. We frequently see negative comments on social media around these out of hours vets fees and questions over how they can be justified. So why are the fees higher and as a pet owner, what do you need to know?
How does veterinary “out of hours” work?
The field of out of hours veterinary services has changed dramatically over the past few decades. Traditionally, independent practices would always do their own out of hours work, and many still do. But the actual provision of services can be variable. Out of hours care in these cases will often either be a lone working nurse, and occasionally vet, staying in the practice, or a single vet taking calls from home, juggling emergencies (maybe even large animal calls in a mixed practice), hospitalised patients and their own sleep.
In these latter cases, it can be common for those patients with minimal needs to be left unattended for potentially long periods overnight, which may be perfectly acceptable, as long as clients are aware of the set-up provided. This way of working can put excessive strain, physically and mentally, on the veterinary staff, who very often will be working a full day on either side of being ‘on-call’, or could be on call for a whole Friday night to Monday morning weekend shift.
The benefits to this structure are that for clients and their pets, they will be seeing the same vets that they will be used to seeing. And usually in the same practice building that they always use. The vets will have access to the animals’ full medical records; and may even be familiar with each case themselves, allowing for case continuity. Also, crucially, unstable patients such as those who have just undergone a major operation, don’t need to be moved to an external out of hours practice for ongoing care.
What’s the alternative?
Over the past twenty years or so, a shift has occurred. Now, more and more small animal practices will outsource their out of hours provision to a dedicated provider. Occasionally, these emergency staff will occupy the primary vets’ premises, but usually, they will be based in a dedicated hospital; only operating outside of usual business hours, and covering the out of hours service for many different practices.
For our pets, this way of working can have massive benefits. Firstly, these staff will only work out of hours, meaning when they start work, they are rested and prepared; rather than having already carried out a full day shift. If you required an operation at 2am, would you want a tired surgeon, or a rested surgeon? A hungry surgeon or one who had eaten? One working alone or as part of a full team?
A hospitalised pet would get the same level of care they would do during the day; ensuring medications are given as required, intravenous fluids are checked regularly and they can be taken out to toilet if needed, which, despite best efforts, may not be possible in a regular practice doing their own out of hours.
Sounds good, so what’s the problem?
Despite their benefits, owners often complain about two major downsides to these dedicated practices. Namely the distance they may have to travel to get there and the costs involved in their pets’ treatment. Because out of hours providers usually cover the service for multiple day practices, they are often located fairly centrally to these practices, in larger towns or cities. This could mean that a client of an outlying practice may have a significantly longer journey time than they would do to their regular vets; which in an emergency situation, can be less than ideal.
But why are they so expensive? The average cost of a routine appointment at a vets in the UK is around £40-60. But an emergency out of hours appointment is between £200 and £300. (This is before any diagnostics or treatment are carried out). Although at first glance, this seems a ridiculous amount just to be seen, there are a number of factors that lead to this figure. Looking at them, you can start to understand why the fees are so much higher.
The main issue is that these places operate on an emergency-only basis
They do not carry out regular appointments such as health checks, vaccinations or nail clipping, or routine procedures such as neutering. In a day practice, these everyday procedures, being high in number but low in cost, will offset the higher costs of any emergency work that may or may not come in. In out of hours practices, they rely solely on emergencies and hospitalised patients. If no emergencies come in, the staff still need to be paid, heating and electricity still need to be on and the building still needs to be insured. Therefore, for each patient they see, the average bill will need to be higher.
Working in these practices also takes a special sort of person
Not only are the hours unsociable and therefore the positions are more difficult to fill, but because they deal with critically ill patients. And they may need to carry out complex procedures so their level of training is likely to be higher. These two factors mean that salaries tend to be higher for staff working in out of hours practices. Therefore fees need to be higher too. The same is true of other professions. An out of hours locum GP can earn over £110 per hour; whereas during regular hours, they would take home on average £40 per hour.
Imagine if out of hours consult fees were the same as in day practice
It would likely mean that more people would use an out of hours vet for non-emergency treatment. For example, maybe their dog has a tick that they need removed, or their cat is scratching. Although in principle, this seems like an acceptable thing to do based on what we said above about offsetting the costs of emergency work, it could mean taking staff away from attending genuine emergencies, adding to their workload unnecessarily and increasing stress levels. By setting consultation fees higher, it means that only those who really need to be seen, can be seen. In 2015, one veterinary franchise tried to start a new business model where routine and emergency cases could be seen around the clock at no extra charge. It didn’t take off.
Plumbers, locksmiths, electricians, even car rental firms, will charge extra to operate outside of normal hours. It’s not unusual, it’s the norm.
Every vet practice in the UK is required to provide their clients with an out of hours provision, whatever form that may take
It’s vital that as a pet owner, you are aware of your practice’s out of hours arrangements in advance of needing them. This is so that you can be prepared for potentially increased journey times and increased costs; without it coming as a shock at what is likely to already be a highly stressful time. It is also worth considering having pet insurance in place; as in the majority of cases, out of hours fees will be covered. With the cost of living ever increasing, veterinary fees, like everything else, are not going to be getting cheaper any time soon.
Owning a pet is a luxury. It is vital that no matter what, no pet is ever left to suffer. So do your research, be prepared and don’t baulk at the bill if your pet ever needs an out of hours vet. Say thank-you and take time to appreciate the staff’s hard work, skill and dedication under increasingly stressful conditions.